Using cancer registry data, the authors identified patients aged 91 days to 14 years (children) and 15 to 19 years (adolescents) who were diagnosed with cancer from 1995-2009, and matched each patient to 3 non-cancer controls. Patients were described in terms of cancer type, comorbidity, and demographics. Researchers used linked health care administrative databases to estimate total and net resource-specific costs (2012 Canadian dollars) during 90 days pre-diagnosis and one year post-diagnosis. Mean net pre-diagnosis costs (per 90 days) were $5,810 for children and $1,127 for adolescents. Mean net post-diagnosis costs in the two cohorts were $136,413 and $62,326 per year for children and adolescents, respectively. Inpatient hospitalization represented 74% and 69% of post-diagnosis net costs for children and adolescents, respectively. Higher rates of hospitalization and higher hospitalization costs in children may explain some of the differences in costs between children and adolescents.

“This study is significant in that it included large, population-based cohorts of children and adolescents along with a comprehensive analysis of the vast majority of health care costs and all major cancer sites,” noted co-authors Claire de Oliveira, PhD, Centre of Addiction and Mental Health, Toronto, Ontario, Canada, and Karen Bremner, BSc, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada. “Furthermore, we believe that accurate estimates of childhood and adolescent cancer costs will provide a valuable scientific foundation for cost-effectiveness analyses of cancer treatments in these patients. Despite the high costs of treatment, cancer care for children may be cost effective due to the dramatic and long-term effects of cancer therapies on overall survival. However, we cannot know this without conducting careful and comprehensive studies to assess cost-effectiveness.”

The authors note that the results of this study are qualitatively similar to those of studies in the United States, Europe, and other provinces in Canada, and are thus likely generalizable to other countries with similar health care systems. Although the direct cost estimates in these and other jurisdictions may differ from those in Ontario, the trends related to age, diagnostic category, and survivorship are common.

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